ABSTRACT:
This cross-sectional study examined the relationship between sickness presenteeism (SP) and work ability (WA) among teachers in the State of São Paulo. A total of 777 teachers from lower secondary to higher education participated, completing four validated self-report instruments: a sociodemographic and work conditions questionnaire, the Work Ability Index (WAI), the Work Limitations Questionnaire (WLQ), and the Organizational Commitment Questionnaire. SP was operationalized using the WLQ total score, dichotomized at the median (≤7 vs. >7). Logistic regression models—hierarchical and final multivariable—estimated associations between explanatory variables and high SP. Overall, 56.6% of teachers exhibited high SP, and 61% reported work limitations in the two weeks preceding data collection. The sample was predominantly female (57%), under 50 years of age (63%), and specialized at the postgraduate level (51%). More than 80% reported working without full physical or mental health, and 59.6% had experienced prior sickness-related absence. Furthermore, 51% and 62% had arrived late or left work early, respectively, due to health problems. Regarding WA, 55% had low or moderate WAI scores (<37 points). High SP was strongly associated with impaired WA: teachers with WAI ≤37 had over six times greater odds of SP compared with those with better WA (OR 6.352; 95% CI 4.472–9.020). Delayed arrival due to health problems increased the likelihood of SP by 65% (OR 1.649; 95% CI 1.135–2.396). Conversely, organizational commitment acted as a protective factor: believing in school values (OR 0.573) and feeling recognized as a group member (OR 0.544) reduced the odds of SP by more than 40%. These findings indicate that SP is highly prevalent among teachers and closely linked to reduced WA, adverse health conditions, and psychosocial work factors. Strengthening organizational support and promoting teacher well-being may mitigate SP and sustain long-term work ability.